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	pageEncoding="UTF-8"%>
<%@ taglib prefix="s" uri="/struts-tags"%>

<html>
  <head>    
    <title>社区初次求诊记录基线资料</title>
    <link rel="stylesheet" type="text/css" href="/healthDoc/css/myStyle.css">  
  </head>
  
  <body>
  	<div style="margin:20px 20px 0px 200px">
  		<h5>1、社区初次求诊记录基线资料：<br />一般资料:</h5>
	</div>
	<div id="patient" style="margin:20px 20px 0px 200px; border: dashed 1px  #777">
		
		<form action="PatientFormEdit" method="post">
		<div>
			<input type="hidden" name="pfId" value="${pfId}" /> 
			<div class="doc">
				<span style="width:65px;text-align:right" >病人姓名:</span>
				<input class="txt" type="text" size="12" name="b3" value="${patient.patientName}" disabled/> 
				
				<span style="width:70px;text-align:right">年龄:</span>
				<input class="txt" type="text" size ="3" name="b4" value="${patient.patientAge}" disabled/>岁
				
				<span style="width:70px;text-align:right">性别:</span>
				<span style="width:100px">
					<s:radio list='#{1:"男", 0:"女"}' name="b5" theme="simple" value="%{patient.patientSex}" disabled="true" /> 
				</span>
				
				<span style="width:80px; text-align:center">健康档案号:</span>
				<input class="txt" type="text" size ="12" 
							name="patientDoc" value="${patient.patientDoc}" disabled/>
			</div>
			<div class="doc">
				<span style="width:65px;text-align:right">家庭地址:</span>
				<input class="txt"  type="text" size="35" name="b6" value="${patient.patientAdd}" disabled/>
				
				<span style="width:65px;text-align:right">邮编:</span>
				<input class="txt" type="text" size ="10" name="b7" value="${patient.patientZip}" disabled/>
				
				<span style="width:65px;text-align:right">电话:</span>
				<input class="txt" type="text" size="12" name="b8" value="${patient.patientTel}" disabled/>
			</div>
			<div class="doc">
					<span style="width:65px;text-align:right">工作单位:</span>
					<input class="txt" type="text" size="35" name="b9" value="${patient.patientOffice}" disabled/>
			</div>
			
			<div class="doc">
				<span style="width:65px;text-align:right">医疗性质:</span>
				<span style="width:120px">离休<input type="checkbox" name="b10" id="ylxz1" value="1"/><label for="ylxz1">省</label><input type="checkbox" name="b10" id="ylxz2" value="2"/><label for="ylxz2">市</label></span>
				<span style="width:120px">医保<input type="checkbox" name="b10" id="ylxz3" value="3"/><label for="ylxz3">省</label><input type="checkbox" name="b10" id="ylxz4" value="4"/><label for="ylxz4">市</label></span>
				<span style="width:120px"><input type="checkbox" name="b10" id="ylxz5"value="5"/><label for="ylxz5">大病保险</label></span>
				<span style="width:120px"><input type="checkbox" name="b10" id="ylxz6" value="6"/><label for="ylxz6">企业</label></span>
				<span style="width:120px"><input type="checkbox" name="b10" id="ylxz7" value="7"/><label for="ylxz7">自费</label></span>
			</div>
			
			<div>
				<span style="width:65px">&nbsp;</span>
				<span style="width:120px"><input type="checkbox" name="b10" id="ylxz8" value="8"/><label for="ylxz8">商业保险</label></span>
				<span style="width:120px"><input type="checkbox" name="b10" id="ylxz9" value="9"/><label for="ylxz9">统筹医疗</label></span>
				<input type="hidden" id="v10" value="${blankList[9].intValue}">
			</div>
			<div class="doc">
				<span style="width:65px;text-align:right">婚姻状况:</span>
				<span>
					<s:checkboxlist name="b11" list='#{1:"单身", 2:"已婚", 3:"离异", 4:"丧偶" }' value="%{blankList[10].intValue}" theme="simple"/> 
				</span>
			</div>
			<div class="doc">
				<span style="width:65px;text-align:right">文化程度:</span>
				<span>
					<s:checkboxlist name="b12" list='#{1:"文盲", 2:"初等", 3:"中等", 4:"高等及以上" }' value="%{blankList[11].intValue}"  theme="simple"/> 
				</span>
			</div>
			<div class="doc">
				<span>身高:</span>
				<input class="txt" type="text" size="4" name="b13" value="${blankList[12].strValue}" />cm
				
				<span style="width:90px;text-align:right">体重:</span>
				<input class="txt" type="text" size ="4" name="b14" value="${blankList[13].strValue}"/>kg
				
				<span style="width:90px;text-align:right">腰围:</span>
				<input class="txt" type="text" size="4" name="b15" value="${blankList[14].strValue}"/>cm
				
			</div>
			<div class="doc">
				<span>血压:</span>
				<input class="txt" type="text" size="8" name="b16" value="${blankList[15].strValue}"/>mmHg
			
				<span style="width:140px;text-align:right">心率:</span>
				<input class="txt" type="text" size ="5" name="b17" value="${blankList[16].strValue}" />次/分
			</div>
			<div class="doc">
				<span style="width:65px;text-align:right">日常锻炼:</span>
				<span style="width:120px"><input type="checkbox" name="b18" id="rcdl1" value="1"/><label for="rcdl1">&gt;1小时/天</label></span>
				<span style="width:120px"><input type="checkbox" name="b18" id="rcdl2" value="2"/><label for="rcdl2">0.5～1小时/天</label></span>
				<span style="width:120px"><input type="checkbox" name="b18" id="rcdl3" value="3"/><label for="rcdl3">&lt;0.5小时/天 </label></span>
				<span>每周次数:<input class="txt" type="text" size="5" name="b19" value="${blankList[19].strValue}" /></span>
				<input type="hidden" id="v18" value="${blankList[17].intValue}" />
			</div>
			 
			<div class="doc">
				<span style="width:65px;text-align:right">吸烟:</span>
				<span style="width:120px"><input type="checkbox" name="b20" id="xy1" value="1"/><label for="xy1">20支/日以上</label></span>
				<span style="width:120px"><input type="checkbox" name="b20" id="xy2" value="2"/><label for="xy2">10~20支/日</label></span>
				<span style="width:120px"><input type="checkbox" name="b20" id="xy3" value="3"/><label for="xy3">0~10支/日</label></span>
			</div>   
			
			<div class="doc">
				<span style="width:65px;text-align:right">&nbsp;</span>
				<span style="width:120px"><input type="checkbox" name="b20" id="xy4" value="4"/><label for="xy4">偶尔</label></span>
				<span style="width:120px"><input type="checkbox" name="b20" id="xy5" value="5"/><label for="xy5">不吸烟</label></span>
				<span><input type="checkbox" name="b20" id="xy6" value="6"/><label for="xy6">戒烟</label></span>
				<span>（时间：<input class="txt" type="text" name="b21" size="3" value="${blankList[20].strValue}" />年）</span>
				<input type="hidden" id="v20" value="${blankList[19].intValue}" />
			</div>  
			
			 
			<div class="doc">
				<span style="width:65px;text-align:right">喝酒:</span>
				<span style="width:160px"><input type="checkbox" name="b22" id="hj1" value="1"/><label for="hj1">多（&gt;25g酒精/日）</label></span>
				<span style="width:90px"><input type="checkbox" name="b22" id="hj2" value="2"/><label for="hj2">少量</label></span>
				<span style="width:90px"><input type="checkbox" name="b22" id="hj3" value="3"/><label for="hj3">无</label></span>
				<span style="width:90px"><input type="checkbox" name="b22" id="hj4" value="4"/><label for="hj4">戒酒</label></span>
				<input type="hidden" id="v22" value="${blankList[21].intValue}" />
			</div>	
		                 
		</div>
		<div align="center" style="margin:20px 0px 20px 0px">
			<input type="submit" value="保存当前">
			<input type="button" value="保存并进入下一步">
		</div>
		</form>
	</div>
	<script language="javascript">
		var arr =new Array(10,18,20,22);
		
		for(j = 0; j < arr.length; j++) {
			var val = document.getElementById("v"+arr[j]);
			var radios = document.getElementsByName("b"+arr[j]);
			
			for(i = 0; i < radios.length; i++) {
				if(radios[i].value == val.value)
					radios[i].checked = "checked";
			}
		}
		
	</script>
  </body>
</html>
